NPIMap

Organization Active NPI

Adventhealth Polk North Inc

Doing business as AdventHealth Heart of Florida

  • General Acute Care Hospital
  • Davenport, FL
National Provider Identifier
1801457510
Registry record updated Jun 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
Legal business name
ADVENTHEALTH POLK NORTH INC
Doing business as
AdventHealth Heart of Florida
Practice address
40100 Highway 27
Davenport, FL 33837-5906
Phone
(863) 419-2259
Fax
(863) 419-2264
NPI assigned
Jun 24, 2019
Last updated
Jun 26, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Alan Justin Hengesbach
Title
Cfo
Phone
(863) 419-2260

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X Primary

Addresses

Primary practice location

40100 Highway 27
Davenport, FL 33837-5906

Mailing address

40100 Highway 27
Davenport, FL 33837-5906
Phone (863) 419-2259

Other practice location 1

14055 Riveredge Dr Ste 250
Tampa, FL 33637-2141
Phone (863) 419-2259

Other names 1

  • AdventHealth Heart of Florida Doing business as

Electronic endpoints 2

TypeEndpointUseAffiliation
CONNECT URL https://www.mettles.com/ Other
CONNECT URL https://www.cms.gov/research-statistics-data-systems/electronic-submission-medical-documentation-esmd/cms-health-information-handler Other CMS HIH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20191001000156 FL Part A Provider - Hospital 1658601968 Practice locations: Davenport, FL; Winter Haven, FL; Winter Garden, FL; Haines City, FL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1801457510. Details of each certification follow.

Hospital certification: CCN 100137

Legal name
ADVENTHEALTH POLK NORTH INC
Doing business as
ADVENTHEALTH HEART OF FLORIDA
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Jun 1, 2019
Beds
268
Ownership / control type
Private (for profit)
Organization structure
CorporationNon-profit
Enrollment address
40100 Highway 27
Davenport, FL 33837-5906
Main/Primary Hospital Location
Hospital subgroups
Acute care

Care Compare: Hospital

Medicare Care Compare
Listed as
Adventhealth Heart of FloridaCCN 100137 · All quality measures
Overall star rating
3 of 5
Type
Acute Care Hospitals
Ownership
Proprietary
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Tax ID family
Adventhealth Polk North Inc4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

2231 North Blvd W
Ste B
Davenport, FL 33837
Phone (863) 419-2360

40124 Highway 27
Ste 103
Davenport, FL 33837
Phone (863) 419-2500

350 1st St N
Fl 2
Winter Haven, FL 33881
Phone (863) 419-2360

Networks

  • Freedom Health HMO NetworkPlans: Freedom Platinum Rewards Plan Rx (HMO) (H5427-102-000, H5427); Freedom VIP Care (HMO C-SNP) (H5427-070-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-108-000, H5427); Freedom VIP Rewards (HMO C-SNP) (H5427-099-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-107-000, H5427); Freedom Máximo (HMO-POS) (H5427-113-000, H5427); Freedom Savings Plan (HMO) (H5427-052-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-096-000, H5427); Freedom Platinum Rewards Plan Rx (HMO) (H5427-105-000, H5427); Freedom Medi-Medi Full (HMO D-SNP) (H5427-087-000, H5427)…
  • Optimum HealthCare HMO NetworkPlans: Optimum Diamond Rewards (HMO C-SNP) (H5594-028-000, H5594); Optimum Diamond (HMO C-SNP) (H5594-036-000, H5594); Optimum Diamond Rewards (HMO C-SNP) (H5594-034-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-029-000, H5594); Optimum Platinum Plan (HMO) (H5594-002-000, H5594); Optimum Gold Plus Plan (HMO) (H5594-032-000, H5594); Optimum Diamond Savings COPD (HMO C-SNP) (H5594-031-000, H5594); Optimum Diamond Savings (HMO C-SNP) (H5594-030-000, H5594); Optimum Diamond Rewards COPD (HMO C-SNP) (H5594-035-000, H5594)

Ownership & related parties

All disclosed owners & managing parties 24

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
James D Guth Individual Corporate DirectorDirector Jan 1, 2024
Jason Dunkel Individual Corporate DirectorDirector Jan 1, 2024
Douglas Hilliard Individual Corporate DirectorDirector Jan 1, 2024
Shane Bedward Individual Corporate DirectorDirector Apr 3, 2025
Jeffrey Graff Individual Corporate OfficerAssistant Secretary Apr 7, 2022
Sumalatha Gangina Individual Corporate DirectorDirector Aug 21, 2025
Gregory a Littleton Individual Corporate DirectorDirector Jan 1, 2024
Timothy Clark Individual Contracted Managing EmployeeCeo Jun 13, 2022
Corporate OfficerCeo Jun 13, 2022
Operational/Managerial ControlCeo Jun 13, 2022
Michael Saunders Individual Corporate OfficerAssistant Secretary Apr 7, 2022
Royce H Brown Individual Corporate DirectorDirector Dec 12, 2024
Amy N Bratten Individual Corporate DirectorDirector Dec 12, 2024
Adventist Health System Sunbelt Healthcare Corporation Organization, Altamonte Springs, FL Corporation, Non-profit, Chain home office 5% Or Greater Direct Ownership Interest Sep 1, 2019 100%
James M Nelson Individual Corporate DirectorDirector Sep 17, 2020
Alan J Hengesbach Individual Contracted Managing EmployeeCfo Jan 2, 2022
Corporate OfficerCfo Jan 2, 2022
Operational/Managerial ControlCfo Jan 2, 2022
Amanda Brady Individual Corporate OfficerAssistant Secretary Apr 7, 2022
Toni Berrios Individual Corporate OfficerAssistant Secretary Jan 1, 2023
Jennifer J Wandersleben Individual Corporate OfficerChair Dec 8, 2022
Corporate DirectorDirector Dec 1, 2021
Haney Vincent Individual Corporate OfficerAssistant Secretary Dec 9, 2021
David L Huffman Individual Corporate OfficerAssistant Secretary Apr 7, 2022
Robert C Foltz Individual Corporate OfficerAssistant Secretary Apr 7, 2022
Lynn Addiscott Individual Corporate OfficerAssistant Secretary Apr 7, 2022
Janice Hagensicker Individual Corporate DirectorDirector Jan 1, 2024
James Santana Individual Operational/Managerial ControlVP Revenue Cycle Aug 1, 2023
Beverly Morgan Individual Corporate OfficerAssistant Secretary Aug 21, 2025

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 85

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 85

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

Affiliated clinicians 458

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 458

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1561334400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719360000000",
    "number": "1801457510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40100 HIGHWAY 27",
            "city": "DAVENPORT",
            "state": "FL",
            "postal_code": "338375906",
            "telephone_number": "863-419-2259",
            "fax_number": "863-419-2264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40100 HIGHWAY 27",
            "city": "DAVENPORT",
            "state": "FL",
            "postal_code": "338375906",
            "telephone_number": "863-419-2259",
            "fax_number": "863-419-2264"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14055 Riveredge Dr Ste 250",
            "address_purpose": "LOCATION",
            "city": "Tampa",
            "state": "FL",
            "postal_code": "336372141",
            "country_code": "US",
            "telephone_number": "863-419-2259",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ADVENTHEALTH POLK NORTH INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-24",
        "last_updated": "2024-06-26",
        "certification_date": "2024-06-26",
        "status": "A",
        "authorized_official_last_name": "HENGESBACH",
        "authorized_official_first_name": "ALAN",
        "authorized_official_middle_name": "JUSTIN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "863-419-2260"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.mettles.com/",
            "affiliation": "N",
            "endpointDescription": "2.16.840.1.113883.3.6037.1",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "10320 Little Patuxent Pkwy Ste 233-02",
            "city": "Columbia",
            "state": "MD",
            "country_code": "US",
            "postal_code": "210443313",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.cms.gov/research-statistics-data-systems/electronic-submission-medical-documentation-esmd/cms-health-information-handler",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.13.34.110.1.998.01",
            "affiliationName": "CMS HIH",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "7500 Security Blvd",
            "city": "Baltimore",
            "state": "MD",
            "country_code": "US",
            "postal_code": "212441849",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "AdventHealth Heart of Florida",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "AdventHealth Heart of Florida",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Davenport, FL

Sources for this page

Verify at the official NPI Registry.